Intravesical chemotherapy
What is it?
Endovesical chemotherapy is an outpatient procedure consisting of intravesical instillation of a chemotherapeutic (mitomycin) or immunotherapeutic (BCG) drug in patients with non-infiltrating bladder cancer in order to prevent recurrence and disease progression
When is this procedure indicated?
Treatment with intravesical instillations of BCG or Chemotherapy, is indicated for patients with superficial bladder disease to prevent the risk of recurrence and disease progression.
How is it performed?
Instillations are performed on an outpatient basis by extemporaneous catheterization. The procedure is performed using a small catheter, emptying the urinary bladder and introducing an intravesical drug, following which the patient is asked to hold the drug in the bladder for approximately one hour. Patients with "Ta" bladder neoplasia are, usually, treated with instillation of a locally acting chemotherapeutic drug, while patients with "T1" tumor are, usually, directed to treatment by a biological drug called BCG (attenuated tuberculosis bacillus). The pattern of bladder instillations varies depending on the drug of use.
Contraindications
Instillations are usually well tolerated and rarely cause systemic effects, which may affect the possibility of continuing treatment. The disorders that may occur more frequently are related to symptomatology of irritative type (increased frequency of urination, urinary urgency and mild burning urination) that resolves at the end of the treatment.
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